Community Chapters 13-15

Which describes ethnocentrism? A. Believing one's own way of life is the best or most desirable B. Understanding similarities between nursing and anthropology C. Imposing one's own beliefs on someone from another culture D. Considering the values and norms that are shared across cultures

A Rationale: Ethnocentrism is a person's tendencies to view his or her own way of life as the most desirable, acceptable, or best and to act in a superior manner toward individuals from another culture. Transcultural nursing acknowledges the philosophical and theoretical similarities between nursing and anthropology. Cultural imposition is a person's tendency to impose his or her own beliefs, values, and patterns of behavior on individuals from another culture. Culture universal refers to the commonalities of values, norms of behavior, and life patterns that are similarly held among cultures about human behavior and lifestyles.

The nurse is teaching a community health class about water quality. Which statement made by a student requires further teaching? A. "Municipalities monitor drinking water for more than 90 organic and inorganic pollutants." B. "Carcinogenic compounds have been found in groundwater, which accounts for half of the U.S. drinking water supply." C. "Water supplies may be contaminated by medications and personal care products that contain endocrine disruptors." D. "Groundwater is especially susceptible to long-term contamination because once it is contaminated, it is impossible to clean."

A Rationale: The Environmental Protection Agency (EPA) monitors drinking water for more than 90 organic and inorganic pollutants. Carcinogenic compounds have been found in groundwater, which accounts for half of the U.S. drinking water supply. Water supplies may be contaminated by medications and personal care products that contain endocrine disruptors. Groundwater is especially susceptible to long-term contamination because once it is contaminated, it is impossible to clean.

Which statement by the community health nurse accurately describes the role of the World Health Organization (WHO)? A. "WHO disseminates global health standards and guidelines." B. "WHO directs and coordinates health efforts at the domestic level." C. "WHO provides low-interest loans and grants to developing countries." D. "WHO helps countries address public health through the Centers for Disease Control and Prevention (CDC)."

A Rationale: WHO is an international organization that disseminates global health standards and guidelines. WHO directs and coordinates health efforts at the international level, not the domestic level. The World Bank, not WHO, provides low-interest loans and grants to developing countries. WHO helps countries address public health through the United Nations, not the CDC.

Which are examples of environmental health problems in the built environment category? Select all that apply. A. Drunk driving B. Secondhand smoke C. Agricultural accidents D. Unsafe neighborhoods E. Nuclear facility emissions

A, B Rationale: Drunk driving and secondhand smoke are examples of environmental health problems in the built environment subcategory. Agricultural accidents are in the category of work-related exposure. Unsafe neighborhoods are in the category of healthy home. Nuclear facility emissions are in the outdoor air quality category.

The nurse working with the community to improve air quality wants to target nonpoint sources. Which will the nurse consider? Select all that apply. A. Urban runoff B. Domestic lawn care C. Air-to-water transfer D. Leaking offshore well E. Factory wastewater discharge

A, B, C Rationale: Nonpoint sources of water pollution include urban runoff, domestic lawn care, and air-to-water transfer. A leaking offshore well and factory wastewater discharge are point sources.

Which food safety steps will the nursing include while teaching a community health class? Select all that apply. A. Chill B. Cook C. Clean D. Separate E. Transport

A, B, C, D Rationale: Proper food safety steps include chill, cook, clean, and separate. Transport is not a necessary step

Which social determinants of population health are associated with persistent socioeconomic disparities worldwide? Select all that apply. A. Medical care B. Total ecology C. Chronic disease D. Health behaviors E. Social characteristics

A, B, D, E Rationale: The social determinants of population health associated with persistent socioeconomic disparities worldwide include total ecology, health behaviors, medical care, and social characteristics. Chronic disease is an adverse outcome of these social determinants.

The nurse working in the emergency department is alerted that the air quality index (AQI) is at 200. The nurse expects to see a rise in the number of patients seeking treatment for which condition? A. Asthma B. Eczema C. Sunburn D. Heat stroke

A. Asthma Rationale: The AQI is used to increase public awareness of air pollution and to provide recommendations for limiting prolonged or heavy exertion outdoors on days when the AQI is high. An AQI of 200 is an unhealthy level, and the nurse can expect to see a rise in the number of patients seeking treatment for asthma. Eczema, sunburn, and heat stroke are not related to air quality.

Which should the nurse include when teaching a group of new nurses about immediate environmental health effects? Select all that apply. A. Gunshot wound B. Inherited disease C. Hurricane damage D. Black lung in coal miners E. Gradual occupational hearing loss

A, C Rationale: Gunshot wounds and hurricane damage are examples of immediate environmental health effects. Inherited diseases are an example of intergenerational health effects. Black lung in coal miners and gradual occupational hearing loss are examples of long-term environmental health effects.

Which nursing roles are appropriate when addressing a community's environmental health? Select all that apply. A. Helping bring about change B. Sharing the nurse's interpretation of the problem C. Helping raise consciousness about environmental dangers D. Eradicating environmental hazards from the environment E. Listening to what community members believe if problematic

A, C, E Rationale: Nurses should help bring about change by listening to what the community believes is problematic and helping raise consciousness about environmental dangers. The nurse should not impose on the community his or her views of the problem. Eradicating environmental hazards is unlikely to be within the nurse's power; moreover, many such hazards cannot be eradicated.

A patient's socioeconomic status is based on what factors? Select all that apply. A. income B. culture C. language D. occupation E. education level

A, D, E Rationale: Socioeconomic status is a composite of the economic status of an individual or family based on factors such as occupation, income, and education level. Culture and language are not factors on which a patient's socioeconomic status is based.

The nurse is teaching patients on conditions related to environmental exposure. Which conditions will the nurse prioritize? Select all that apply. A. Cancer B. Asthma C. Headaches D. Birth defects E. Nervous system damage

A, D, E Rationale: The most serious conditions related to environmental exposure are irreversible, debilitating, and life-threatening. These include cancer, birth defects, and nervous system damage. Asthma and headaches are less serious.

A nurse is performing a needs assessment to implement a health promotion program in communities with high poverty rates. What is the largest portion of this population that the nurse identifies as most in need of a health promotion program? A. Children B. Male adults C. Older adults D. Female adults

A. Children Rationale: Poverty among children in the United States has risen in all racial and ethnic groups and in all geographic settings. According to the U.S. Census Bureau, the poverty rate for children in 2012 was 21.8% higher than for any other age group. Children in poverty are at a high risk for lack of adequate nutrition and brain development. Approximately 10.5% of adult men and 14% of the adult female population lives in poverty. Poverty rates for older adults are lower, largely because of improvements in Social Security and the Supplemental Security Income program.

What U.S. model of care is being developed in other countries to bridge the gap between hospital- and community-based care? A. Home health care B. Skilled nursing facilities C. Long-term care facilities D. Public health departments

A. Home health care Rationale: Home health care is being developed in many other countries to bridge the gap between hospital- and community-based care. Skilled nursing facilities, long-term care facilities, and public health departments are community-based centers of care.

Which major pollutant can adversely affect mental development and performance, kidney function, and blood chemistry? A. Lead B. Ozone C. Carbon monoxide D. Particulate matter

A. Lead Rationale: Lead can adversely affect mental development and performance, kidney function, and blood chemistry. Ozone can irritate the respiratory tract, impair lung function, and cause throat irritation, chest pain, cough, and susceptibility to lung infection. Carbon monoxide reduces the ability of the blood to deliver oxygen to vital tissues. It primarily affects the cardiovascular and nervous systems. Particulate matter can affect breathing and elicit respiratory symptoms, causing increased respiratory disease and lung damage.

Which infection was the original reason for the creation of the Centers for Disease Control and Prevention (CDC)? A. Malaria B. Zika Virus C. Pneumonia D. Tuberculosis

A. Malaria Rationale: The CDC was originally created in 1946 to help control the spread of malaria. Subsequently, the CDC developed programs to address a number of public health concerns, including Zika virus, pneumonia, and tuberculosis.

Which model for nursing care is most effective in addressing the challenges of inefficient health care delivery in the global community? A. Public health nursing B. Population-based nursing C. Primary health care nursing D. Community public health nursing

A. Public health nursing Rationale: Population-based nursing is the model of nursing that is most effective in addressing the challenges of inefficient health care delivery in the global community. Population-based nursing focuses on entire populations possessing similar health concerns or characteristics. The major goal of public health nursing is to preserve the health of the community and surrounding populations by focusing on health promotion and health maintenance of individuals, families, and groups within the community. Primary health care nursing provides essential services that support a healthy life. Primary care is not the norm for health care delivery in international communities. Community public health nursing is associated with health and the identification of populations at risk rather than with an episodic response to patient demand.

Which component of public health is targeted by addressing litter as an environmental stressor? A. Quality of life B. Human health C. Damaged goods D. Ecological balance

A. Quality of life Rationale: Eliminating the environmental stressor of litter in the neighborhood addresses quality of life for residents. Human health is affected by environmental stressors that cause illness, such as in the case of lead poisoning. Damaged goods result from an environmental stressor like air pollution. Ecological balance is affected by environmental stressors on a larger scale, like global warming.

Which factor is the greatest mediator of childhood obesity? A. Race B. Gender C. Ethnicity D. Socioeconomic status

D. Socioeconomic status Rationale: Socioeconomic status was found to be a greater mediator of childhood obesity than race, gender, or ethnicity.

Which is a characteristic of culture? A. Stays the same for a group over time B. Learned from birth through socialization C. Varies among members of a cultural group D. Remains constant regardless of environment

B Rationale: Culture is learned from birth through the processes of language acquisition and socialization. Culture does not stay the same. It is dynamic, meaning it changes over time and in response to environment and other factors. Culture is shared by members of the same cultural group. Culture adapts to specific conditions related to environmental and technical factors and also to availability of natural resources.

The nurse educator is assessing student knowledge of values and norms as related to culture. Which statement made by a student indicates a need for further education on this topic? A. "In all cultures, values and norms are learned in childhood." B. "Values are the rules by which groups govern human behavior." C. "All societies have norms that tell what kinds of behaviors are appropriate." D. "Types of values differ from culture to culture, but their presences is universal."

B Rationale: Norms are the rules by which human behavior is governed; norms result from cultural values held by a group. The other statements are correct. Values and norms are learned in childhood. All societies have rules or norms that specify appropriate and inappropriate behaviors. Values are a universal feature of all cultures, although the types and expressions of values differ widely.

The collaborative team that is focused on the World Health Organization (WHO) goal of primary health care understands that which component is a key element in achieving the goal? A. Identifying economic barriers B. Integrating health into all sectors C. Promoting nontraditional medicine D. Ensuring social accountability for all providers

B Rationale: The collaborative team that is focused on the WHO goal of primary health care understands that integrating health into all sectors is one of the key elements in achieving the goal. Identifying economic barriers, promoting nontraditional medicine, and ensuring social accountability for all providers are not identified key elements in achieving the WHO goal of primary health care.

Which describes transcultural nursing? A. Believing one's own way of life is the best or most desirable B. Understanding similarities between nursing and anthropology C. Imposing one's own beliefs on someone from another culture D. Considering the values and norms that are shared across cultures

B Rationale: Transcultural nursing acknowledges the philosophical and theoretical similarities between nursing and anthropology. Ethnocentrism is a person's tendencies to view his or her own way of life as the most desirable, acceptable, or best and to act in a superior manner toward individuals from another culture. Cultural imposition is a person's tendency to impose his or her own beliefs, values, and patterns of behavior on individuals from another culture. Culture universal refers to the commonalities of values, norms of behavior, and life patterns that are similarly held among cultures about human behavior and lifestyles.

Which statement made by a student, after a community nursing presentation, indicates understanding of water quality? A."Municipalities monitor drinking water for more than 90 organic and inorganic pollutants." B. "Water supplies may be contaminated by medication and personal care products that contain endocrine disruptors." C. "River and lake waters are especially susceptible to long-term contamination because once contaminated they are impossible to clean." D. " Carcinogenic compounds have been found in groundwater, but it only accounts for a small percentage of the U.S. drinking water supply."

B Rationale: Water supplies may be contaminated by medications and personal care products that contain endocrine disruptors. The Environmental Protection Agency (EPA) monitors drinking water for more than 90 organic and inorganic pollutants. Groundwater is especially susceptible to long-term contamination because once it is contaminated, it is impossible to clean. Carcinogenic compounds have been found in groundwater, which accounts for half of the U.S. drinking water supply.

Which elements make up an individual's socioeconomic status (SES)? Select all that apply. A. Health B. Wealth C. Income D. Occupation E. Education level

B, C, D, E Rationale: SES is a composite of the economic status of a family or unrelated individuals based on income, wealth, occupation, educational attainment, and power. Health is not included in the conceptualization of SES.

In which ways can an environmental health history assessment benefit a patient? Select all that apply A. Removes hazards from the environment B. Identifies potential environmental hazards C. Improves timelines and accuracy of diagnosis D. Prevents disease and aggravation of conditions E. Increases awareness of environmental health concerns

B, C, D, E Rationale: Taking an environmental health history can benefit a patient by identifying potential environmental hazards, improving timelines and accuracy of diagnosis, preventing disease and aggravation of conditions, and increasing awareness of environmental health concerns. Removing a hazard from the environment is not always possible or appropriate and is not the patient's responsibility.

Which guidelines should the nurse follow when attempting to overcome language barriers when an interpreter is not available? Select all that apply. A. Speaking informally B. Trying a third language C. Speaking with simple words D. Using contractions to simplify E. Discussing one topic at a time

B, C, E Rationale: When communicating with a patient for whom there is a language barrier, the nurse should try a third language if possible. Many Indo-Chinese people speak French. Europeans often know three or four languages. The nurse should try Latin words or phrases. The nurse should use simple words, such as "pain" instead of "discomfort." The nurse should discuss one topic at a time, for example asking "Does your head hurt?" and then asking "Does your stomach hurt?" The nurse should be polite and formal. The nurse should avoid use of contractions and should speak in simple sentences.

During an assessment, the new patient describes living with a spouse and the spouse's daughter from a previous marriage. How will the nurse document this family structure in the patient's record? A. Nuclear B. Blended C. Extended D. Nuclear dyad

B. Blended Rationale: A blended family is one in which there is a husband, wife, and children from previous relationships. A nuclear family has a husband, wife, and child or children. An extended family includes the nuclear family plus other blood relatives. A nuclear dyad is a husband and wife alone, either childless or with no children living at home.

Which food product can become contaminated when farmers spray dioxin on rangeland? A. Eggs B. Beef C. Corn D. Potatoes

B. Beef Rationale: Farmers spray dioxin-containing weed killers on rangeland, where beef cattle graze. The herbicide accumulates in their fatty tissue, and the contaminated meat is sold in markets. The complexity of transfer of these contaminants makes it difficult to establish causality and tracing accountability for these health risks. Rangeland is not used for eggs, corn, or potatoes.

The public health nurse is reviewing disease prevalence across the globe. Which disease process is the most common cause of morbidity and mortality in underdeveloped countries? A. Cancer B. Infectious disease C. Respiratory disease D. Cardiovascular disease

B. Infectious disease Rationale: Infectious diseases are the most common cause of morbidity and mortality in underdeveloped countries because of poor sanitation, malnutrition, and lack of immunization. Chronic disease such as cancers, respiratory disease, and cardiovascular disease occur more frequently in developed, industrialized nations where factors such as pollution and a longer lifespan lead to a higher prevalence of chronic disease.

The only food shopping options in a patient's neighborhood are fast food and convenience stores that do not stock any fresh fruits or vegetables. Which term describes this neighborhood? A. Food bank B. Food island C. Food desert D. Food locked

C Rationale: A food desert is a neighborhood with little to not access to healthy foods. A food bank is a resource through which people in poverty can obtain food. The terms food island and food locked are not used to describe neighborhoods with little or no access to healthy foods.

Which behavior by a farm worker can put his or her children at risk for pesticide exposure? A. Showering and changing at home after work B. Avoiding work after toxic pesticide exposure C. Wearing the same clothes in the field and at home D. Following proper application procedures for specific pesticides

C Rationale: Farm workers and pesticide applicators who accumulate agricultural chemicals on their skin and clothing take these substances home with them, increasing their children's exposure to toxicants. Farm workers should shower and change clothes after work. Wearing the same clothes in the field and at home can put the farm worker's children at risk. The worker should avoid work for as long as indicated after a toxic pesticide exposure. The farm worker will limit risks to health by following proper application for specific pesticides.

Which response by the public health nurse reflects the focus of the Healthy People 2020 campaign? A. "It focuses on health in China and Africa." B. "It is a 5-year program for health improvement." C. "It provides science-based interventions for improving public health." D. "It works toward economic development to sustain health in the population."

C Rationale: Healthy People 2020 provides science-based interventions for improving public health. It focuses on health in the United States, not in China or Africa. Healthy People 2020 is a 10-year, not 5-year, program for health improvement. The World Bank works toward economic development to sustain health in the population. This work is not a focus of the Healthy People 2020 campaign.

How is the role of the nurse affected in less-developed countries? A. The role is advanced B. The role is nonexistent C. The role is poorly defined D. The role assumes increased autonomy

C Rationale: In less-developed countries, the role of the nurse is poorly defined, if at all, and care often depends on and is directed by physicians. It is not necessarily advanced, but it does exist. It does not always increase autonomy.

The community health nurse is teaching a group about global health promotion, including leading causes of death. Which statement by a participant reflects an adequate understanding of the leading cause of death? A. "Pneumonia is the leading cause of death." B. "Lung cancer is the leading cause of death." C. "Ischemic heart disease and stroke are the leading causes of death." D. "Chronic obstructive pulmonary disease (COPD) is the leading cause of death."

C Rationale: Ischemic heart disease and stroke are the leading causes of death, accounting for 54% of mortalities worldwide. After ischemic heart disease and stroke, other leading causes of death are pneumonia; lung, tracheal, and bronchial cancers; COPD; and diabetes.

How does socioeconomic status (SES) affect the accessibility and use of healthcare services? A. SES affects whether or not patients will want to receive healthcare services B. SES causes providers to make patients wait longer to receive their healthcare services C. SES often dictates the patient's ability to purchase insurance or pay providers for care D. SES requires some patients to pay more money to providers for their time and services

C Rationale: Patients with low socioeconomic status sometimes cannot afford to purchase private insurance and may not be able to pay for healthcare services out of pocket. Socioeconomic status does not affect whether or not a patient wants services; the patient may want services but may be unable to pay for them or vice versa. Socioeconomic status does not cause providers to make patients wait longer to receive healthcare services because all patients should be treated equally, regardless of status. Socioeconomic status does not require some patients to pay more money for their time and services because healthcare services should cost the same amount for all patients.

The public health nurse delivering a talk about environmental health is asked what the residents can do to decrease land pollution. Which nursing response is appropriate? A. "Avoid paper products." B. "Use chemical fertilizers" C. "Purchase reusable goods." D. "Treat gardens with synthetic pesticides."

C Rationale: Purchasing reusable goods reduces land pollution when it replaces disposable goods. Paper is preferred for decreasing land pollution (compared with plastics). Both chemical fertilizers and synthetic pesticides contribute to land pollution and reduce the use of natural control methods.

In what area is the Centers for Disease Control and Prevention (CDC) globally recognized? A. Improving the health and living standards of the Americas B. Establishing health-related initiatives to promote sustainable economic growth C. Conducting research and investigations and taking an action-oriented approach D. Improving children's survival, development, and protection through community-based programs

C Rationale: The CDC is globally recognized for conducting research and investigations and taking an action-oriented approach. The CDC applies research and findings to improve people's daily lives and responds to health emergencies—a feature that distinguishes the CDC from many of its peer agencies. The Pan American Health Organization (PAHO) is an international public health agency working to improve the health and living standards of the Americas. It serves as the regional office of the World Health Organization (WHO) and is recognized as part of the United Nations system. World Bank Health develops health-related initiatives to promote sustainable economic growth. The United Nations International Children's Emergency Fund (UNICEF) is focused on the goals of children's survival, development, and protection through community-based programs.

Which agency will the public health nurse suggest when asked which health agency is best to contact for public health research? A. Bill and Melinda Gates Foundation B. International Council of Nurses (ICN) C. Centers for Disease Control and Prevention (CDC) D. U.S. Department of Health and Human Services (DHHS)

C Rationale: The CDC is well-known and respected for its involvement in action-oriented research. The Bill and Melinda Gates Foundation could be suggested for public health work specific to Africa. The ICN promotes equality in nursing care across the world. While the U.S. DHHS oversees the CDC, the CDC itself conducts the research.

Which examples reflect objectives of Healthy People 2020 specific to environmental health? Select all that apply. A. Reduce outdoor allergen levels B. Increase visits to healthcare facilities for pesticide exposure C. Reduce the amount of toxic pollutants released into the environment D. Decrease the number of American homes with lead-based paint or related hazards E. Minimize the risks to human health and the environment posed by hazardous sites

C, D, E Rationale: Examples of Healthy People 2020 objectives related to the environment include reducing the amount of toxic pollutants released into the environment, minimizing the risks to human health and the environment posed by hazardous sites, and decreasing the number of American homes with lead-based paint or related hazards. Reducing indoor, not outdoor, allergen levels is a Healthy People 2020 objective related to environmental health. Another objective is to reduce the number of visits to healthcare facilities for pesticide exposure by reducing the occurrence of exposure.

Which are examples of environmental health problems in the work-related exposure category? Select all that apply. A. Drunk driving B. Secondhand smoke C. Agricultural accidents D. Unsafe neighborhoods E. Excessive exposure to x-rays

C, E Rationale: Agricultural accidents and excessive exposure to x-rays are examples in the category of work-related exposure. Drunk driving and secondhand smoke are examples of environmental health problems in the built environment subcategory. Unsafe neighborhoods are in the category of healthy home.

Which factors contributing to death and disease burden are classified as environmental? Select all that apply. A. Exercise B. Food access C. Air pollution D. Family history E. Climate changes F. Chemical exposure

C, E, F Rationale: Environmental risk factors include air pollution, climate changes, chemical exposure, water pollution, soil pollution, and exposure to radiation. Exercise, food access, and family history do contribute to death and disease burden but are not environmental risk factors.

Which program would the public health nurse associate with the World Health Organization (WHO)? A. Code of Nurses B. Healthy People 2020 C. Health for all by the year 2000 D. Millennium Development Goals

C. Rationale: The WHO set the goal of health for all by the year 2000. The Code for Nurses was created by the International Council of Nurses. Healthy People 2020 is managed by the U.S. Department of Health and Human Services. The Millennium Development Goals were developed by the United Nations.

A patient reports dizziness, headaches, and fatigue and tells the nurse he or she works in an office directly above the building's parking garage. Which pollutant does the nurse suspect may be the cause of the patient's symptoms? A. Asbestos B. Formaldehyde C. Carbon monoxide D. Volatile organic compounds

C. Rationale: Commercial buildings with offices near underground parking garages may cause workers to develop carbon monoxide intoxication, marked by dizziness, headaches, and fatigue. Asbestos, formaldehyde, and volatile organic compounds may also be related to sick building syndrome, but these are not specifically associated with parking garages or the noted symptoms.

While teaching a nutrition class, the community nurse explains that genetically modified (GM) foods may put the population at increased risk for which type of disease? A. Endocrine B. Neurological C. Autoimmune D. Cardiovascular

C. Autoimmune Rationale: There is concern that genetic alteration of food is growing despite the fact that the long-term health effects of eating GM food are unknown. Some believe that autoimmune problems may proliferate because unique antigens are present on GM proteins. GM foods are not specifically linked to raising the risk for endocrine, neurological, and cardiovascular diseases.

Half of the world's air pollution can be attributed to which chemical? A. Sulfur oxide B. Hydrocarbons C. Carbon monoxide D. Nitrogen monoxide

C. Carbon monoxide Rationale: Half of the world's air pollution can be attributed to carbon monoxide. Combined with carbon monoxide and particulate matter, sulfur oxide, hydrocarbons, and nitrogen monoxide account for 90% of the world's pollution.

What is the primary focus of the World Health Organization (WHO) international nurse who provides care for infants in less-developed countries? A. HIV/AIDS B. Malnutrition C. Respiratory disease D. Nonimmunized infants and children

C. Respiratory disease Rationale: The primary focus of the WHO international nurse who provides care for infants and children in less-developed countries is respiratory disease. At present, infants and children in less-developed countries experience high death rates related to respiratory and diarrheal diseases. HIV/AIDS, malnutrition, and disease related to nonimmunization contribute to the morbidity and mortality rate of infants and children.

The public health nurse is developing a plan for global distribution of the malaria vaccine. Which climate zone will the nurse target? A. Arid B. Polar C. Tropical D. Temperate

C. Tropical Rationale: Malaria is spread through mosquitos in tropical and subtropical areas of the world. Arid, polar, and temperate climate zones do not sustain mosquitos and therefore do not support the spread of malaria.

Which source of drinking water is impossible to clean once it has become contaminated? A. Lake B. River C. Reservoir D. Groundwater

D Rationale: Contamination of groundwater is especially tragic because unlike lakes, rivers, and reservoirs, groundwater is impossible to clean.

Which statement by the nurse indicates the need for further education on solutions to healthcare problems among culturally diverse populations? A. "Collaborating with community resources will benefit my work." B. "It's important to foster caring relationships with the population." C. "The community should set the priorities and needs for my efforts." D. "Care should be focused on physical health in order to solve problems."

D Rationale: In addressing healthcare problems among culturally diverse populations, the nurse should provide care for the whole person: mental, physical, emotional, social, spiritual, and environmental aspects. The other statements reflect understanding of solving healthcare problems in culturally diverse populations. The nurse should collaborate with community resources to reach healthcare goals. The nurse should establish caring relationships with the communities, families, and individuals in the population. Nursing care should reflect community priorities and needs.

Which approach to identifying the root cause of obesity will the nurse use when working with a population with a high rate of obesity? A. Targeting lifestyle contributors B. Identifying subpopulations at highest risk C. Implementing preventable behavioral changes D. Integrating environmental and genetic information

D Rationale: Integrating environmental and genetic information allows the nurse to develop better understanding about health outcomes and health behavior. Targeting lifestyle contributors and identifying subpopulations at risk may be inadequate, as research has shown that there are multiple environmental and genetic factors at play in obesity, and both must be targeted to identify the root cause. Implementing behavioral changes will help fight obesity but will not help identify the cause.

Which describes the role of changing individual behaviors in affecting overall morbidity and mortality? A. Individual behavior changes are the most influential factor in reducing morbidity and mortality B. Individual behavior changes do not affect morbidity and mortality because they cannot overcome genetic predispositions C. Social, economic, and political changes cannot happen without individuals first changing their own behaviors to reduce morbidity and mortality D. Changing individual behaviors does not lead to significant reductions in morbidity and mortality in the absence of social, economic, and political changes

D Rationale: Research suggests that changing individual behaviors does not lead to significant reductions in overall morbidity and mortality in the absence of basic social, economic, and political changes. Individual behavior changes are not the most influential factor in reducing morbidity and mortality, but they can overcome some genetic predispositions. Social, economic, and political change may support and enable individual behavior change.

Which statement is best when working to overcome a language barrier without an interpreter? A. "Do you feel discomfort?" B. "Do your head and stomach hurt?" C. "Put it on your rash in the morning." D. "Do not take your medicine with food."

D Rationale: When communicating with a patient for whom there is a language barrier, the nurse should avoid use of contractions and should speak in simple sentences. The nurse should use simple words, such as "pain" instead of "discomfort." The nurse should discuss one topic at a time, for example asking "Does your head hurt?" and then asking "Does your stomach hurt?" The nurse should say nouns repeatedly instead of using pronouns. For example, the nurse should say "Put the cream on your rash in the morning."

The nurse is working with the community to improve air quality and wants to target point sources. Which will the nurse consider? Select all that apply. A. Urban runoff B. Domestic lawn care C. Air-to-water transfer D. Leaking offshore well E. Factory wastewater discharge

D, E Rationale: A leaking offshore well and factory wastewater discharge are point sources. Nonpoint sources of water pollution include urban runoff, domestic lawn care, and air-to-water transfer.

Which should the nurse include when teaching a group of new nurses about long-term environmental health effects? Select all that apply. A. Gunshot wound B. Inherited disease C. Hurricane damage D. Black lung in coal miners E. Gradual occupational hearing loss

D, E Rationale: Black lung in coal miners and gradual occupational hearing loss are examples of long-term environmental health effects. Gunshot wounds and hurricane damage are examples of immediate environmental health effects. Inherited diseases are an example of intergenerational health effects.

Which constellation in which people live together in society includes an unmarried man and woman sharing a household with or without children? A. Blended B. Extended C. Communal D. Cohabitation

D. Cohabitation Rationale: Cohabitation involves an unmarried man and woman sharing a household with or without children. A blended family is one in which there is a husband, wife, and children from previous relationships. An extended family includes the nuclear family plus other blood relatives. A communal living situation includes a group of men and women with or without children.

Which is considered the most important factor in determining socioeconomic status (SES)? A. Wealth B. Income C. Occupation D. Education level

D. Education level Rationale: SES is a composite of the economic status of a family or unrelated individuals based on income, wealth, occupation, educational attainment, and power. Educational attainment is the single most important factor.

A nurse practitioner is providing care to a newly arrived refugee with diabetes. What financial assistance is available for the patient to continue with treatment? A. Medicaid B. Private pay C. State assistance D. Medical assistance

D. Medical assistance Rationale: The financial assistance that is available to the newly arrived refugee diagnosed with diabetes is medical assistance. Medical assistance is available during the first 18 months in the United States. The newly arrived refugee is ineligible for Medicaid or state assistance. The patient may choose to privately pay at any time or after medical assistance has expired.

Which global health organization was developed specifically to address the health needs of children? A. UN B. CDC C. WHO D. UNICEF

D. UNICEF Rationale: The United Nations International Children's Emergency Fund (UNICEF) was developed specifically to target the health needs of children. Programs run by the United Nations (UN), Centers for Disease Control and Prevention (CDC), and World Health Organization (WHO) include those addressing children's health but were also designed to address health needs across the lifespan.

Which is the country of origin and focus for the Centers for Disease Control and Prevention (CDC)? A. China B. Japan C. France D. United States

D. United States Rationale: The CDC is based in the United States and focuses on American public health. China, Japan, and France may be addressed by actions of the global organizations such as the United Nations and World Bank.